Certified Hospice Program

Medicaid Rate Sheet

Effective: 10/01/2017 – 09/30/2018

  • Rates also available in Excel Format (XLSX)
Table of Contents
Albany–Schenectady–Troy
Binghamton
Buffalo
Elmira
Glens Falls
Nassau Suffolk
New York City
Niagara Falls
Orange County
Poughkeepsie
Rochester
Syracuse
Utica–Rome
Rural

SMSA: Albany–Schenectady–Troy

Hospice Rate Sheets for the Counties of: ALBANY, GREENE, MONTGOMERY, RENSSELAER, SARATOGA, SCHENECTADY

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $141.76 $4.25 $9.92 $155.93
3946 Inpatient Respite $164.32 $4.93 $9.92 $179.17
3947 General Inpatient Care $658.69 $19.76 $9.92 $688.37
3948 Continuous Home Care – Min 8 Hours $285.71 $8.57 $9.92 $304.20
3949 Continuous Home Care – Min 9 Hours $321.42 $9.64 $9.92 $340.98
3950 Continuous Home Care – Min 10 Hours $357.14 $10.71 $9.92 $377.77
3951 Continuous Home Care – Min 11 Hours $392.85 $11.79 $9.92 $414.56
3952 Continuous Home Care – Min 12 Hours $428.57 $12.86 $9.92 $451.35
3953 Continuous Home Care – Min 13 Hours $464.28 $13.93 $9.92 $488.13
3954 Continuous Home Care – Min 14 Hours $499.99 $15.00 $9.92 $524.91
3955 Continuous Home Care – Min 15 Hours $535.71 $16.07 $9.92 $561.70
3956 Continuous Home Care – Min 16 Hours $571.42 $17.14 $9.92 $598.48
3957 Continuous Home Care – Min 17 Hours $607.13 $18.21 $9.92 $635.26
3958 Continuous Home Care – Min 18 Hours $642.85 $19.29 $9.92 $672.06
3959 Continuous Home Care – Min 19 Hours $678.56 $20.36 $9.92 $708.84
3960 Continuous Home Care – Min 20 Hours $714.28 $21.43 $9.92 $745.63
3961 Continuous Home Care – Min 21 Hours $749.99 $22.50 $9.92 $782.41
3962 Continuous Home Care – Min 22 Hours $785.70 $23.57 $9.92 $819.19
3963 Continuous Home Care – Min 23 Hours $821.42 $24.64 $9.92 $855.98
3964 Continuous Home Care – Min 24 Hours $857.13 $25.71 $9.92 $892.76
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.22 $0.25 $0.50 $8.97
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $245.57 $7.37 $9.92 $262.86
3970 Routine Home Care w/Escort $159.50 $4.79 $9.92 $174.21
3971 Continuous Home Care w/AIDS Min 8 Hours $299.41 $8.98 $9.92 $318.31
3972 Continuous Home Care w/AIDS Min 9 Hours $336.84 $10.11 $9.92 $356.87
3973 Continuous Home Care w/AIDS Min 10 Hours $374.26 $11.23 $9.92 $395.41
3974 Continuous Home Care w/AIDS Min 11 Hours $411.69 $12.35 $9.92 $433.96
3975 Continuous Home Care w/AIDS Min 12 Hours $449.12 $13.47 $9.92 $472.51
3976 Continuous Home Care w/AIDS Min 13 Hours $486.54 $14.60 $9.92 $511.06
3977 Continuous Home Care w/AIDS Min 14 Hours $523.97 $15.72 $9.92 $549.61
3978 Continuous Home Care w/AIDS Min 15 Hours $561.39 $16.84 $9.92 $588.15
3979 Continuous Home Care w/AIDS Min 16 Hours $598.82 $17.96 $9.92 $626.70
3980 Continuous Home Care w/AIDS Min 17 Hours $636.25 $19.09 $9.92 $665.26
3981 Continuous Home Care w/AIDS Min 18 Hours $673.67 $20.21 $9.92 $703.80
3982 Continuous Home Care w/AIDS Min 19 Hours $711.10 $21.33 $9.92 $742.35
3983 Continuous Home Care w/AIDS Min 20 Hours $748.53 $22.46 $9.92 $780.91
3984 Continuous Home Care w/AIDS Min 21 Hours $785.95 $23.58 $9.92 $819.45
3985 Continuous Home Care w/AIDS Min 22 Hours $823.38 $24.70 $9.92 $858.00
3986 Continuous Home Care w/AIDS Min 23 Hours $860.80 $25.82 $9.92 $896.54
3987 Continuous Home Care w/AIDS Min 24 Hours $898.23 $26.95 $9.92 $935.10
3988 General Inpatient w/ AIDS $732.07 $21.96 $9.92 $763.95
3989 Routine Home Care w/ AIDS Escort $263.31 $7.90 $9.92 $281.13
3991 Service Intensity Add–on $36.95 $1.11 $0.00 $38.06

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Binghamton

Hospice Rate Sheets for the Counties of: BROOME, TIOGA

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $145.13 $4.35 $9.92 $159.40
3946 Inpatient Respite $167.31 $5.02 $9.92 $182.25
3947 General Inpatient Care $673.16 $20.19 $9.92 $703.27
3948 Continuous Home Care – Min 8 Hours $292.51 $8.78 $9.92 $311.21
3949 Continuous Home Care – Min 9 Hours $329.08 $9.87 $9.92 $348.87
3950 Continuous Home Care – Min 10 Hours $365.64 $10.97 $9.92 $386.53
3951 Continuous Home Care – Min 11 Hours $402.21 $12.07 $9.92 $424.20
3952 Continuous Home Care – Min 12 Hours $438.77 $13.16 $9.92 $461.85
3953 Continuous Home Care – Min 13 Hours $475.33 $14.26 $9.92 $499.51
3954 Continuous Home Care – Min 14 Hours $511.90 $15.36 $9.92 $537.18
3955 Continuous Home Care – Min 15 Hours $548.46 $16.45 $9.92 $574.83
3956 Continuous Home Care – Min 16 Hours $585.03 $17.55 $9.92 $612.50
3957 Continuous Home Care – Min 17 Hours $621.59 $18.65 $9.92 $650.16
3958 Continuous Home Care – Min 18 Hours $658.16 $19.74 $9.92 $687.82
3959 Continuous Home Care – Min 19 Hours $694.72 $20.84 $9.92 $725.48
3960 Continuous Home Care – Min 20 Hours $731.28 $21.94 $9.92 $763.14
3961 Continuous Home Care – Min 21 Hours $767.85 $23.04 $9.92 $800.81
3962 Continuous Home Care – Min 22 Hours $804.41 $24.13 $9.92 $838.46
3963 Continuous Home Care – Min 23 Hours $840.98 $25.23 $9.92 $876.13
3964 Continuous Home Care – Min 24 Hours $877.54 $26.33 $9.92 $913.79
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.37 $0.25 $0.50 $9.12
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $251.42 $7.54 $9.92 $268.88
3970 Routine Home Care w/Escort $162.87 $4.89 $9.92 $177.68
3971 Continuous Home Care w/AIDS Min 8 Hours $309.46 $9.28 $9.92 $328.66
3972 Continuous Home Care w/AIDS Min 9 Hours $348.14 $10.44 $9.92 $368.50
3973 Continuous Home Care w/AIDS Min 10 Hours $386.83 $11.60 $9.92 $408.35
3974 Continuous Home Care w/AIDS Min 11 Hours $425.51 $12.77 $9.92 $448.20
3975 Continuous Home Care w/AIDS Min 12 Hours $464.19 $13.93 $9.92 $488.04
3976 Continuous Home Care w/AIDS Min 13 Hours $502.87 $15.09 $9.92 $527.88
3977 Continuous Home Care w/AIDS Min 14 Hours $541.56 $16.25 $9.92 $567.73
3978 Continuous Home Care w/AIDS Min 15 Hours $580.24 $17.41 $9.92 $607.57
3979 Continuous Home Care w/AIDS Min 16 Hours $618.92 $18.57 $9.92 $647.41
3980 Continuous Home Care w/AIDS Min 17 Hours $657.60 $19.73 $9.92 $687.25
3981 Continuous Home Care w/AIDS Min 18 Hours $696.29 $20.89 $9.92 $727.10
3982 Continuous Home Care w/AIDS Min 19 Hours $734.97 $22.05 $9.92 $766.94
3983 Continuous Home Care w/AIDS Min 20 Hours $773.65 $23.21 $9.92 $806.78
3984 Continuous Home Care w/AIDS Min 21 Hours $812.33 $24.37 $9.92 $846.62
3985 Continuous Home Care w/AIDS Min 22 Hours $851.02 $25.53 $9.92 $886.47
3986 Continuous Home Care w/AIDS Min 23 Hours $889.70 $26.69 $9.92 $926.31
3987 Continuous Home Care w/AIDS Min 24 Hours $928.38 $27.85 $9.92 $966.15
3988 General Inpatient w/ AIDS $748.15 $22.44 $9.92 $780.51
3989 Routine Home Care w/ AIDS Escort $269.16 $8.07 $9.92 $287.15
3991 Service Intensity Add–on $37.83 $1.13 $0.00 $38.96

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Buffalo

Hospice Rate Sheets for the Counties of: ERIE

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $167.17 $5.02 $9.92 $182.11
3946 Inpatient Respite $186.85 $5.61 $9.92 $202.38
3947 General Inpatient Care $767.63 $23.03 $9.92 $800.58
3948 Continuous Home Care – Min 8 Hours $336.92 $10.11 $9.92 $356.95
3949 Continuous Home Care – Min 9 Hours $379.04 $11.37 $9.92 $400.33
3950 Continuous Home Care – Min 10 Hours $421.15 $12.63 $9.92 $443.70
3951 Continuous Home Care – Min 11 Hours $463.27 $13.90 $9.92 $487.09
3952 Continuous Home Care – Min 12 Hours $505.38 $15.16 $9.92 $530.46
3953 Continuous Home Care – Min 13 Hours $547.50 $16.43 $9.92 $573.85
3954 Continuous Home Care – Min 14 Hours $589.61 $17.69 $9.92 $617.22
3955 Continuous Home Care – Min 15 Hours $631.73 $18.95 $9.92 $660.60
3956 Continuous Home Care – Min 16 Hours $673.84 $20.22 $9.92 $703.98
3957 Continuous Home Care – Min 17 Hours $715.96 $21.48 $9.92 $747.36
3958 Continuous Home Care – Min 18 Hours $758.07 $22.74 $9.92 $790.73
3959 Continuous Home Care – Min 19 Hours $800.19 $24.01 $9.92 $834.12
3960 Continuous Home Care – Min 20 Hours $842.30 $25.27 $9.92 $877.49
3961 Continuous Home Care – Min 21 Hours $884.42 $26.53 $9.92 $920.87
3962 Continuous Home Care – Min 22 Hours $926.53 $27.80 $9.92 $964.25
3963 Continuous Home Care – Min 23 Hours $968.65 $29.06 $9.92 $1,007.63
3964 Continuous Home Care – Min 24 Hours $1,010.76 $30.32 $9.92 $1,051.00
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $9.34 $0.28 $0.50 $10.12
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $289.59 $8.69 $9.92 $308.20
3970 Routine Home Care w/Escort $184.91 $5.55 $9.92 $200.38
3971 Continuous Home Care w/AIDS Min 8 Hours $375.07 $11.25 $9.92 $396.24
3972 Continuous Home Care w/AIDS Min 9 Hours $421.96 $12.66 $9.92 $444.54
3973 Continuous Home Care w/AIDS Min 10 Hours $468.84 $14.07 $9.92 $492.83
3974 Continuous Home Care w/AIDS Min 11 Hours $515.73 $15.47 $9.92 $541.12
3975 Continuous Home Care w/AIDS Min 12 Hours $562.61 $16.88 $9.92 $589.41
3976 Continuous Home Care w/AIDS Min 13 Hours $609.49 $18.28 $9.92 $637.69
3977 Continuous Home Care w/AIDS Min 14 Hours $656.38 $19.69 $9.92 $685.99
3978 Continuous Home Care w/AIDS Min 15 Hours $703.26 $21.10 $9.92 $734.28
3979 Continuous Home Care w/AIDS Min 16 Hours $750.15 $22.50 $9.92 $782.57
3980 Continuous Home Care w/AIDS Min 17 Hours $797.03 $23.91 $9.92 $830.86
3981 Continuous Home Care w/AIDS Min 18 Hours $843.92 $25.32 $9.92 $879.16
3982 Continuous Home Care w/AIDS Min 19 Hours $890.80 $26.72 $9.92 $927.44
3983 Continuous Home Care w/AIDS Min 20 Hours $937.68 $28.13 $9.92 $975.73
3984 Continuous Home Care w/AIDS Min 21 Hours $984.57 $29.54 $9.92 $1,024.03
3985 Continuous Home Care w/AIDS Min 22 Hours $1,031.45 $30.94 $9.92 $1,072.31
3986 Continuous Home Care w/AIDS Min 23 Hours $1,078.34 $32.35 $9.92 $1,120.61
3987 Continuous Home Care w/AIDS Min 24 Hours $1,125.22 $33.76 $9.92 $1,168.90
3988 General Inpatient w/ AIDS $853.14 $25.59 $9.92 $888.65
3989 Routine Home Care w/ AIDS Escort $307.33 $9.22 $9.92 $326.47
3991 Service Intensity Add–on $43.57 $1.31 $0.00 $44.88

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Elmira

Hospice Rate Sheets for the Counties of: CHEMUNG

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $148.16 $4.44 $9.92 $162.52
3946 Inpatient Respite $170.00 $5.10 $9.92 $185.02
3947 General Inpatient Care $686.15 $20.58 $9.92 $716.65
3948 Continuous Home Care – Min 8 Hours $298.62 $8.96 $9.92 $317.50
3949 Continuous Home Care – Min 9 Hours $335.95 $10.08 $9.92 $355.95
3950 Continuous Home Care – Min 10 Hours $373.28 $11.20 $9.92 $394.40
3951 Continuous Home Care – Min 11 Hours $410.60 $12.32 $9.92 $432.84
3952 Continuous Home Care – Min 12 Hours $447.93 $13.44 $9.92 $471.29
3953 Continuous Home Care – Min 13 Hours $485.26 $14.56 $9.92 $509.74
3954 Continuous Home Care – Min 14 Hours $522.59 $15.68 $9.92 $548.19
3955 Continuous Home Care – Min 15 Hours $559.91 $16.80 $9.92 $586.63
3956 Continuous Home Care – Min 16 Hours $597.24 $17.92 $9.92 $625.08
3957 Continuous Home Care – Min 17 Hours $634.57 $19.04 $9.92 $663.53
3958 Continuous Home Care – Min 18 Hours $671.90 $20.16 $9.92 $701.98
3959 Continuous Home Care – Min 19 Hours $709.22 $21.28 $9.92 $740.42
3960 Continuous Home Care – Min 20 Hours $746.55 $22.40 $9.92 $778.87
3961 Continuous Home Care – Min 21 Hours $783.88 $23.52 $9.92 $817.32
3962 Continuous Home Care – Min 22 Hours $821.21 $24.64 $9.92 $855.77
3963 Continuous Home Care – Min 23 Hours $858.53 $25.76 $9.92 $894.21
3964 Continuous Home Care – Min 24 Hours $895.86 $26.88 $9.92 $932.66
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.50 $0.26 $0.50 $9.26
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $256.67 $7.70 $9.92 $274.29
3970 Routine Home Care w/Escort $165.90 $4.98 $9.92 $180.80
3971 Continuous Home Care w/AIDS Min 8 Hours $318.48 $9.55 $9.92 $337.95
3972 Continuous Home Care w/AIDS Min 9 Hours $358.29 $10.75 $9.92 $378.96
3973 Continuous Home Care w/AIDS Min 10 Hours $398.10 $11.94 $9.92 $419.96
3974 Continuous Home Care w/AIDS Min 11 Hours $437.91 $13.14 $9.92 $460.97
3975 Continuous Home Care w/AIDS Min 12 Hours $477.73 $14.33 $9.92 $501.98
3976 Continuous Home Care w/AIDS Min 13 Hours $517.54 $15.53 $9.92 $542.99
3977 Continuous Home Care w/AIDS Min 14 Hours $557.35 $16.72 $9.92 $583.99
3978 Continuous Home Care w/AIDS Min 15 Hours $597.16 $17.91 $9.92 $624.99
3979 Continuous Home Care w/AIDS Min 16 Hours $636.97 $19.11 $9.92 $666.00
3980 Continuous Home Care w/AIDS Min 17 Hours $676.78 $20.30 $9.92 $707.00
3981 Continuous Home Care w/AIDS Min 18 Hours $716.59 $21.50 $9.92 $748.01
3982 Continuous Home Care w/AIDS Min 19 Hours $756.40 $22.69 $9.92 $789.01
3983 Continuous Home Care w/AIDS Min 20 Hours $796.21 $23.89 $9.92 $830.02
3984 Continuous Home Care w/AIDS Min 21 Hours $836.02 $25.08 $9.92 $871.02
3985 Continuous Home Care w/AIDS Min 22 Hours $875.83 $26.27 $9.92 $912.02
3986 Continuous Home Care w/AIDS Min 23 Hours $915.64 $27.47 $9.92 $953.03
3987 Continuous Home Care w/AIDS Min 24 Hours $955.45 $28.66 $9.92 $994.03
3988 General Inpatient w/ AIDS $762.59 $22.88 $9.92 $795.39
3989 Routine Home Care w/ AIDS Escort $274.41 $8.23 $9.92 $292.56
3991 Service Intensity Add–on $38.62 $1.16 $0.00 $39.78

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Glens Falls

Hospice Rate Sheets for the Counties of:WARREN, WASHINGTON

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $139.82 $4.19 $9.92 $153.93
3946 Inpatient Respite $162.59 $4.88 $9.92 $177.39
3947 General Inpatient Care $650.36 $19.51 $9.92 $679.79
3948 Continuous Home Care – Min 8 Hours $281.80 $8.45 $9.92 $300.17
3949 Continuous Home Care – Min 9 Hours $317.02 $9.51 $9.92 $336.45
3950 Continuous Home Care – Min 10 Hours $352.25 $10.57 $9.92 $372.74
3951 Continuous Home Care – Min 11 Hours $387.47 $11.62 $9.92 $409.01
3952 Continuous Home Care – Min 12 Hours $422.70 $12.68 $9.92 $445.30
3953 Continuous Home Care – Min 13 Hours $457.92 $13.74 $9.92 $481.58
3954 Continuous Home Care – Min 14 Hours $493.14 $14.79 $9.92 $517.85
3955 Continuous Home Care – Min 15 Hours $528.37 $15.85 $9.92 $554.14
3956 Continuous Home Care – Min 16 Hours $563.59 $16.91 $9.92 $590.42
3957 Continuous Home Care – Min 17 Hours $598.82 $17.96 $9.92 $626.70
3958 Continuous Home Care – Min 18 Hours $634.04 $19.02 $9.92 $662.98
3959 Continuous Home Care – Min 19 Hours $669.27 $20.08 $9.92 $699.27
3960 Continuous Home Care – Min 20 Hours $704.49 $21.13 $9.92 $735.54
3961 Continuous Home Care – Min 21 Hours $739.72 $22.19 $9.92 $771.83
3962 Continuous Home Care – Min 22 Hours $774.94 $23.25 $9.92 $808.11
3963 Continuous Home Care – Min 23 Hours $810.17 $24.31 $9.92 $844.40
3964 Continuous Home Care – Min 24 Hours $845.39 $25.36 $9.92 $880.67
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.13 $0.24 $0.50 $8.87
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $242.21 $7.27 $9.92 $259.40
3970 Routine Home Care w/Escort $157.56 $4.73 $9.92 $172.21
3971 Continuous Home Care w/AIDS Min 8 Hours $293.63 $8.81 $9.92 $312.36
3972 Continuous Home Care w/AIDS Min 9 Hours $330.33 $9.91 $9.92 $350.16
3973 Continuous Home Care w/AIDS Min 10 Hours $367.03 $11.01 $9.92 $387.96
3974 Continuous Home Care w/AIDS Min 11 Hours $403.74 $12.11 $9.92 $425.77
3975 Continuous Home Care w/AIDS Min 12 Hours $440.44 $13.21 $9.92 $463.57
3976 Continuous Home Care w/AIDS Min 13 Hours $477.14 $14.31 $9.92 $501.37
3977 Continuous Home Care w/AIDS Min 14 Hours $513.85 $15.42 $9.92 $539.19
3978 Continuous Home Care w/AIDS Min 15 Hours $550.55 $16.52 $9.92 $576.99
3979 Continuous Home Care w/AIDS Min 16 Hours $587.25 $17.62 $9.92 $614.79
3980 Continuous Home Care w/AIDS Min 17 Hours $623.96 $18.72 $9.92 $652.60
3981 Continuous Home Care w/AIDS Min 18 Hours $660.66 $19.82 $9.92 $690.40
3982 Continuous Home Care w/AIDS Min 19 Hours $697.36 $20.92 $9.92 $728.20
3983 Continuous Home Care w/AIDS Min 20 Hours $734.07 $22.02 $9.92 $766.01
3984 Continuous Home Care w/AIDS Min 21 Hours $770.77 $23.12 $9.92 $803.81
3985 Continuous Home Care w/AIDS Min 22 Hours $807.47 $24.22 $9.92 $841.61
3986 Continuous Home Care w/AIDS Min 23 Hours $844.18 $25.33 $9.92 $879.43
3987 Continuous Home Care w/AIDS Min 24 Hours $880.88 $26.43 $9.92 $917.23
3988 General Inpatient w/ AIDS $722.81 $21.68 $9.92 $754.41
3989 Routine Home Care w/ AIDS Escort $259.95 $7.80 $9.92 $277.67
3991 Service Intensity Add–on $36.45 $1.09 $0.00 $37.54

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Nassau Suffolk

Hospice Rate Sheets for the Counties of: NASSAU, SUFFOLK

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $191.53 $5.75 $9.92 $207.20
3946 Inpatient Respite $208.46 $6.25 $9.92 $224.63
3947 General Inpatient Care $872.10 $26.16 $9.92 $908.18
3948 Continuous Home Care – Min 8 Hours $386.03 $11.58 $9.92 $407.53
3949 Continuous Home Care – Min 9 Hours $434.28 $13.03 $9.92 $457.23
3950 Continuous Home Care – Min 10 Hours $482.53 $14.48 $9.92 $506.93
3951 Continuous Home Care – Min 11 Hours $530.79 $15.92 $9.92 $556.63
3952 Continuous Home Care – Min 12 Hours $579.04 $17.37 $9.92 $606.33
3953 Continuous Home Care – Min 13 Hours $627.29 $18.82 $9.92 $656.03
3954 Continuous Home Care – Min 14 Hours $675.55 $20.27 $9.92 $705.74
3955 Continuous Home Care – Min 15 Hours $723.80 $21.71 $9.92 $755.43
3956 Continuous Home Care – Min 16 Hours $772.05 $23.16 $9.92 $805.13
3957 Continuous Home Care – Min 17 Hours $820.31 $24.61 $9.92 $854.84
3958 Continuous Home Care – Min 18 Hours $868.56 $26.06 $9.92 $904.54
3959 Continuous Home Care – Min 19 Hours $916.81 $27.50 $9.92 $954.23
3960 Continuous Home Care – Min 20 Hours $965.07 $28.95 $9.92 $1,003.94
3961 Continuous Home Care – Min 21 Hours $1,013.32 $30.40 $9.92 $1,053.64
3962 Continuous Home Care – Min 22 Hours $1,061.57 $31.85 $9.92 $1,103.34
3963 Continuous Home Care – Min 23 Hours $1,109.83 $33.29 $9.92 $1,153.04
3964 Continuous Home Care – Min 24 Hours $1,158.08 $34.74 $9.92 $1,202.74
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $10.42 $0.31 $0.50 $11.23
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $331.80 $9.95 $9.92 $351.67
3970 Routine Home Care w/Escort $209.27 $6.28 $9.92 $225.47
3971 Continuous Home Care w/AIDS Min 8 Hours $447.63 $13.43 $9.92 $470.98
3972 Continuous Home Care w/AIDS Min 9 Hours $503.58 $15.11 $9.92 $528.61
3973 Continuous Home Care w/AIDS Min 10 Hours $559.53 $16.79 $9.92 $586.24
3974 Continuous Home Care w/AIDS Min 11 Hours $615.49 $18.46 $9.92 $643.87
3975 Continuous Home Care w/AIDS Min 12 Hours $671.44 $20.14 $9.92 $701.50
3976 Continuous Home Care w/AIDS Min 13 Hours $727.39 $21.82 $9.92 $759.13
3977 Continuous Home Care w/AIDS Min 14 Hours $783.35 $23.50 $9.92 $816.77
3978 Continuous Home Care w/AIDS Min 15 Hours $839.30 $25.18 $9.92 $874.40
3979 Continuous Home Care w/AIDS Min 16 Hours $895.25 $26.86 $9.92 $932.03
3980 Continuous Home Care w/AIDS Min 17 Hours $951.21 $28.54 $9.92 $989.67
3981 Continuous Home Care w/AIDS Min 18 Hours $1,007.16 $30.21 $9.92 $1,047.29
3982 Continuous Home Care w/AIDS Min 19 Hours $1,063.11 $31.89 $9.92 $1,104.92
3983 Continuous Home Care w/AIDS Min 20 Hours $1,119.07 $33.57 $9.92 $1,162.56
3984 Continuous Home Care w/AIDS Min 21 Hours $1,175.02 $35.25 $9.92 $1,220.19
3985 Continuous Home Care w/AIDS Min 22 Hours $1,230.97 $36.93 $9.92 $1,277.82
3986 Continuous Home Care w/AIDS Min 23 Hours $1,286.93 $38.61 $9.92 $1,335.46
3987 Continuous Home Care w/AIDS Min 24 Hours $1,342.88 $40.29 $9.92 $1,393.09
3988 General Inpatient w/ AIDS $969.25 $29.08 $9.92 $1,008.25
3989 Routine Home Care w/ AIDS Escort $349.54 $10.49 $9.92 $369.95
3991 Service Intensity Add–on $49.92 $1.50 $0.00 $51.42

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: New York City

Hospice Rate Sheets for the Counties of: BRONX, KINGS, NEW YORK, PUTNAM, QUEENS, RICHMOND, ROCKLAND, WESTCHESTER

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $193.61 $5.81 $9.92 $209.34
3946 Inpatient Respite $210.30 $6.31 $9.92 $226.53
3947 General Inpatient Care $881.00 $26.43 $9.92 $917.35
3948 Continuous Home Care – Min 8 Hours $390.21 $11.71 $9.92 $411.84
3949 Continuous Home Care – Min 9 Hours $438.99 $13.17 $9.92 $462.08
3950 Continuous Home Care – Min 10 Hours $487.76 $14.63 $9.92 $512.31
3951 Continuous Home Care – Min 11 Hours $536.54 $16.10 $9.92 $562.56
3952 Continuous Home Care – Min 12 Hours $585.32 $17.56 $9.92 $612.80
3953 Continuous Home Care – Min 13 Hours $634.09 $19.02 $9.92 $663.03
3954 Continuous Home Care – Min 14 Hours $682.87 $20.49 $9.92 $713.28
3955 Continuous Home Care – Min 15 Hours $731.64 $21.95 $9.92 $763.51
3956 Continuous Home Care – Min 16 Hours $780.42 $23.41 $9.92 $813.75
3957 Continuous Home Care – Min 17 Hours $829.20 $24.88 $9.92 $864.00
3958 Continuous Home Care – Min 18 Hours $877.97 $26.34 $9.92 $914.23
3959 Continuous Home Care – Min 19 Hours $926.75 $27.80 $9.92 $964.47
3960 Continuous Home Care – Min 20 Hours $975.53 $29.27 $9.92 $1,014.72
3961 Continuous Home Care – Min 21 Hours $1,024.30 $30.73 $9.92 $1,064.95
3962 Continuous Home Care – Min 22 Hours $1,073.08 $32.19 $9.92 $1,115.19
3963 Continuous Home Care – Min 23 Hours $1,121.85 $33.66 $9.92 $1,165.43
3964 Continuous Home Care – Min 24 Hours $1,170.63 $35.12 $9.92 $1,215.67
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $10.52 $0.32 $0.50 $11.34
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $335.39 $10.06 $9.92 $355.37
3970 Routine Home Care w/Escort $211.35 $6.34 $9.92 $227.61
3971 Continuous Home Care w/AIDS Min 8 Hours $453.81 $13.61 $9.92 $477.34
3972 Continuous Home Care w/AIDS Min 9 Hours $510.53 $15.32 $9.92 $535.77
3973 Continuous Home Care w/AIDS Min 10 Hours $567.26 $17.02 $9.92 $594.20
3974 Continuous Home Care w/AIDS Min 11 Hours $623.98 $18.72 $9.92 $652.62
3975 Continuous Home Care w/AIDS Min 12 Hours $680.71 $20.42 $9.92 $711.05
3976 Continuous Home Care w/AIDS Min 13 Hours $737.44 $22.12 $9.92 $769.48
3977 Continuous Home Care w/AIDS Min 14 Hours $794.16 $23.82 $9.92 $827.90
3978 Continuous Home Care w/AIDS Min 15 Hours $850.89 $25.53 $9.92 $886.34
3979 Continuous Home Care w/AIDS Min 16 Hours $907.61 $27.23 $9.92 $944.76
3980 Continuous Home Care w/AIDS Min 17 Hours $964.34 $28.93 $9.92 $1,003.19
3981 Continuous Home Care w/AIDS Min 18 Hours $1,021.07 $30.63 $9.92 $1,061.62
3982 Continuous Home Care w/AIDS Min 19 Hours $1,077.79 $32.33 $9.92 $1,120.04
3983 Continuous Home Care w/AIDS Min 20 Hours $1,134.52 $34.04 $9.92 $1,178.48
3984 Continuous Home Care w/AIDS Min 21 Hours $1,191.24 $35.74 $9.92 $1,236.90
3985 Continuous Home Care w/AIDS Min 22 Hours $1,247.97 $37.44 $9.92 $1,295.33
3986 Continuous Home Care w/AIDS Min 23 Hours $1,304.69 $39.14 $9.92 $1,353.75
3987 Continuous Home Care w/AIDS Min 24 Hours $1,361.42 $40.84 $9.92 $1,412.18
3988 General Inpatient w/ AIDS $979.14 $29.37 $9.92 $1,018.43
3989 Routine Home Care w/ AIDS Escort $353.13 $10.59 $9.92 $373.64
3991 Service Intensity Add–on $50.46 $1.51 $0.00 $51.97

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Niagara Falls

Hospice Rate Sheets for the Counties of: NIAGARA

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $167.17 $5.02 $9.92 $182.11
3946 Inpatient Respite $186.85 $5.61 $9.92 $202.38
3947 General Inpatient Care $767.63 $23.03 $9.92 $800.58
3948 Continuous Home Care – Min 8 Hours $336.92 $10.11 $9.92 $356.95
3949 Continuous Home Care – Min 9 Hours $379.04 $11.37 $9.92 $400.33
3950 Continuous Home Care – Min 10 Hours $421.15 $12.63 $9.92 $443.70
3951 Continuous Home Care – Min 11 Hours $463.27 $13.90 $9.92 $487.09
3952 Continuous Home Care – Min 12 Hours $505.38 $15.16 $9.92 $530.46
3953 Continuous Home Care – Min 13 Hours $547.50 $16.43 $9.92 $573.85
3954 Continuous Home Care – Min 14 Hours $589.61 $17.69 $9.92 $617.22
3955 Continuous Home Care – Min 15 Hours $631.73 $18.95 $9.92 $660.60
3956 Continuous Home Care – Min 16 Hours $673.84 $20.22 $9.92 $703.98
3957 Continuous Home Care – Min 17 Hours $715.96 $21.48 $9.92 $747.36
3958 Continuous Home Care – Min 18 Hours $758.07 $22.74 $9.92 $790.73
3959 Continuous Home Care – Min 19 Hours $800.19 $24.01 $9.92 $834.12
3960 Continuous Home Care – Min 20 Hours $842.30 $25.27 $9.92 $877.49
3961 Continuous Home Care – Min 21 Hours $884.42 $26.53 $9.92 $920.87
3962 Continuous Home Care – Min 22 Hours $926.53 $27.80 $9.92 $964.25
3963 Continuous Home Care – Min 23 Hours $968.65 $29.06 $9.92 $1,007.63
3964 Continuous Home Care – Min 24 Hours $1,010.76 $30.32 $9.92 $1,051.00
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $9.34 $0.28 $0.50 $10.12
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $289.59 $8.69 $9.92 $308.20
3970 Routine Home Care w/Escort $184.91 $5.55 $9.92 $200.38
3971 Continuous Home Care w/AIDS Min 8 Hours $375.07 $11.25 $9.92 $396.24
3972 Continuous Home Care w/AIDS Min 9 Hours $421.96 $12.66 $9.92 $444.54
3973 Continuous Home Care w/AIDS Min 10 Hours $468.84 $14.07 $9.92 $492.83
3974 Continuous Home Care w/AIDS Min 11 Hours $515.73 $15.47 $9.92 $541.12
3975 Continuous Home Care w/AIDS Min 12 Hours $562.61 $16.88 $9.92 $589.41
3976 Continuous Home Care w/AIDS Min 13 Hours $609.49 $18.28 $9.92 $637.69
3977 Continuous Home Care w/AIDS Min 14 Hours $656.38 $19.69 $9.92 $685.99
3978 Continuous Home Care w/AIDS Min 15 Hours $703.26 $21.10 $9.92 $734.28
3979 Continuous Home Care w/AIDS Min 16 Hours $750.15 $22.50 $9.92 $782.57
3980 Continuous Home Care w/AIDS Min 17 Hours $797.03 $23.91 $9.92 $830.86
3981 Continuous Home Care w/AIDS Min 18 Hours $843.92 $25.32 $9.92 $879.16
3982 Continuous Home Care w/AIDS Min 19 Hours $890.80 $26.72 $9.92 $927.44
3983 Continuous Home Care w/AIDS Min 20 Hours $937.68 $28.13 $9.92 $975.73
3984 Continuous Home Care w/AIDS Min 21 Hours $984.57 $29.54 $9.92 $1,024.03
3985 Continuous Home Care w/AIDS Min 22 Hours $1,031.45 $30.94 $9.92 $1,072.31
3986 Continuous Home Care w/AIDS Min 23 Hours $1,078.34 $32.35 $9.92 $1,120.61
3987 Continuous Home Care w/AIDS Min 24 Hours $1,125.22 $33.76 $9.92 $1,168.90
3988 General Inpatient w/ AIDS $853.14 $25.59 $9.92 $888.65
3989 Routine Home Care w/ AIDS Escort $307.33 $9.22 $9.92 $326.47
3991 Service Intensity Add–on $43.57 $1.31 $0.00 $44.88

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Orange

Hospice Rate Sheets for the Counties of: ORANGE

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $193.61 $5.81 $9.92 $209.34
3946 Inpatient Respite $210.30 $6.31 $9.92 $226.53
3947 General Inpatient Care $881.00 $26.43 $9.92 $917.35
3948 Continuous Home Care – Min 8 Hours $390.21 $11.71 $9.92 $411.84
3949 Continuous Home Care – Min 9 Hours $438.99 $13.17 $9.92 $462.08
3950 Continuous Home Care – Min 10 Hours $487.76 $14.63 $9.92 $512.31
3951 Continuous Home Care – Min 11 Hours $536.54 $16.10 $9.92 $562.56
3952 Continuous Home Care – Min 12 Hours $585.32 $17.56 $9.92 $612.80
3953 Continuous Home Care – Min 13 Hours $634.09 $19.02 $9.92 $663.03
3954 Continuous Home Care – Min 14 Hours $682.87 $20.49 $9.92 $713.28
3955 Continuous Home Care – Min 15 Hours $731.64 $21.95 $9.92 $763.51
3956 Continuous Home Care – Min 16 Hours $780.42 $23.41 $9.92 $813.75
3957 Continuous Home Care – Min 17 Hours $829.20 $24.88 $9.92 $864.00
3958 Continuous Home Care – Min 18 Hours $877.97 $26.34 $9.92 $914.23
3959 Continuous Home Care – Min 19 Hours $926.75 $27.80 $9.92 $964.47
3960 Continuous Home Care – Min 20 Hours $975.53 $29.27 $9.92 $1,014.72
3961 Continuous Home Care – Min 21 Hours $1,024.30 $30.73 $9.92 $1,064.95
3962 Continuous Home Care – Min 22 Hours $1,073.08 $32.19 $9.92 $1,115.19
3963 Continuous Home Care – Min 23 Hours $1,121.85 $33.66 $9.92 $1,165.43
3964 Continuous Home Care – Min 24 Hours $1,170.63 $35.12 $9.92 $1,215.67
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $10.52 $0.32 $0.50 $11.34
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $335.39 $10.06 $9.92 $355.37
3970 Routine Home Care w/Escort $211.35 $6.34 $9.92 $227.61
3971 Continuous Home Care w/AIDS Min 8 Hours $453.81 $13.61 $9.92 $477.34
3972 Continuous Home Care w/AIDS Min 9 Hours $510.53 $15.32 $9.92 $535.77
3973 Continuous Home Care w/AIDS Min 10 Hours $567.26 $17.02 $9.92 $594.20
3974 Continuous Home Care w/AIDS Min 11 Hours $623.98 $18.72 $9.92 $652.62
3975 Continuous Home Care w/AIDS Min 12 Hours $680.71 $20.42 $9.92 $711.05
3976 Continuous Home Care w/AIDS Min 13 Hours $737.44 $22.12 $9.92 $769.48
3977 Continuous Home Care w/AIDS Min 14 Hours $794.16 $23.82 $9.92 $827.90
3978 Continuous Home Care w/AIDS Min 15 Hours $850.89 $25.53 $9.92 $886.34
3979 Continuous Home Care w/AIDS Min 16 Hours $907.61 $27.23 $9.92 $944.76
3980 Continuous Home Care w/AIDS Min 17 Hours $964.34 $28.93 $9.92 $1,003.19
3981 Continuous Home Care w/AIDS Min 18 Hours $1,021.07 $30.63 $9.92 $1,061.62
3982 Continuous Home Care w/AIDS Min 19 Hours $1,077.79 $32.33 $9.92 $1,120.04
3983 Continuous Home Care w/AIDS Min 20 Hours $1,134.52 $34.04 $9.92 $1,178.48
3984 Continuous Home Care w/AIDS Min 21 Hours $1,191.24 $35.74 $9.92 $1,236.90
3985 Continuous Home Care w/AIDS Min 22 Hours $1,247.97 $37.44 $9.92 $1,295.33
3986 Continuous Home Care w/AIDS Min 23 Hours $1,304.69 $39.14 $9.92 $1,353.75
3987 Continuous Home Care w/AIDS Min 24 Hours $1,361.42 $40.84 $9.92 $1,412.18
3988 General Inpatient w/ AIDS $979.14 $29.37 $9.92 $1,018.43
3989 Routine Home Care w/ AIDS Escort $353.13 $10.59 $9.92 $373.64
3991 Service Intensity Add–on $50.46 $1.51 $0.00 $51.97

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Poughkeepsie

Hospice Rate Sheets for the Counties of: DUTCHESS

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $176.31 $5.29 $9.92 $191.52
3946 Inpatient Respite $194.96 $5.85 $9.92 $210.73
3947 General Inpatient Care $806.85 $24.21 $9.92 $840.98
3948 Continuous Home Care – Min 8 Hours $355.35 $10.66 $9.92 $375.93
3949 Continuous Home Care – Min 9 Hours $399.77 $11.99 $9.92 $421.68
3950 Continuous Home Care – Min 10 Hours $444.19 $13.33 $9.92 $467.44
3951 Continuous Home Care – Min 11 Hours $488.61 $14.66 $9.92 $513.19
3952 Continuous Home Care – Min 12 Hours $533.03 $15.99 $9.92 $558.94
3953 Continuous Home Care – Min 13 Hours $577.45 $17.32 $9.92 $604.69
3954 Continuous Home Care – Min 14 Hours $621.87 $18.66 $9.92 $650.45
3955 Continuous Home Care – Min 15 Hours $666.29 $19.99 $9.92 $696.20
3956 Continuous Home Care – Min 16 Hours $710.71 $21.32 $9.92 $741.95
3957 Continuous Home Care – Min 17 Hours $755.13 $22.65 $9.92 $787.70
3958 Continuous Home Care – Min 18 Hours $799.55 $23.99 $9.92 $833.46
3959 Continuous Home Care – Min 19 Hours $843.96 $25.32 $9.92 $879.20
3960 Continuous Home Care – Min 20 Hours $888.38 $26.65 $9.92 $924.95
3961 Continuous Home Care – Min 21 Hours $932.80 $27.98 $9.92 $970.70
3962 Continuous Home Care – Min 22 Hours $977.22 $29.32 $9.92 $1,016.46
3963 Continuous Home Care – Min 23 Hours $1,021.64 $30.65 $9.92 $1,062.21
3964 Continuous Home Care – Min 24 Hours $1,066.06 $31.98 $9.92 $1,107.96
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $9.75 $0.29 $0.50 $10.54
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $305.43 $9.16 $9.92 $324.51
3970 Routine Home Care w/Escort $194.05 $5.82 $9.92 $209.79
3971 Continuous Home Care w/AIDS Min 8 Hours $402.31 $12.07 $9.92 $424.30
3972 Continuous Home Care w/AIDS Min 9 Hours $452.60 $13.58 $9.92 $476.10
3973 Continuous Home Care w/AIDS Min 10 Hours $502.89 $15.09 $9.92 $527.90
3974 Continuous Home Care w/AIDS Min 11 Hours $553.18 $16.60 $9.92 $579.70
3975 Continuous Home Care w/AIDS Min 12 Hours $603.47 $18.10 $9.92 $631.49
3976 Continuous Home Care w/AIDS Min 13 Hours $653.75 $19.61 $9.92 $683.28
3977 Continuous Home Care w/AIDS Min 14 Hours $704.04 $21.12 $9.92 $735.08
3978 Continuous Home Care w/AIDS Min 15 Hours $754.33 $22.63 $9.92 $786.88
3979 Continuous Home Care w/AIDS Min 16 Hours $804.62 $24.14 $9.92 $838.68
3980 Continuous Home Care w/AIDS Min 17 Hours $854.91 $25.65 $9.92 $890.48
3981 Continuous Home Care w/AIDS Min 18 Hours $905.20 $27.16 $9.92 $942.28
3982 Continuous Home Care w/AIDS Min 19 Hours $955.49 $28.66 $9.92 $994.07
3983 Continuous Home Care w/AIDS Min 20 Hours $1,005.78 $30.17 $9.92 $1,045.87
3984 Continuous Home Care w/AIDS Min 21 Hours $1,056.06 $31.68 $9.92 $1,097.66
3985 Continuous Home Care w/AIDS Min 22 Hours $1,106.35 $33.19 $9.92 $1,149.46
3986 Continuous Home Care w/AIDS Min 23 Hours $1,156.64 $34.70 $9.92 $1,201.26
3987 Continuous Home Care w/AIDS Min 24 Hours $1,206.93 $36.21 $9.92 $1,253.06
3988 General Inpatient w/ AIDS $896.73 $26.90 $9.92 $933.55
3989 Routine Home Care w/ AIDS Escort $323.17 $9.70 $9.92 $342.79
3991 Service Intensity Add–on $45.96 $1.38 $0.00 $47.34

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Rochester

Hospice Rate Sheets for the Counties of: LIVINGSTON, MONROE, ONTARIO, ORLEANS, WAYNE

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $144.80 $4.34 $9.92 $159.06
3946 Inpatient Respite $167.01 $5.01 $9.92 $181.94
3947 General Inpatient Care $671.73 $20.15 $9.92 $701.80
3948 Continuous Home Care – Min 8 Hours $291.84 $8.76 $9.92 $310.52
3949 Continuous Home Care – Min 9 Hours $328.32 $9.85 $9.92 $348.09
3950 Continuous Home Care – Min 10 Hours $364.80 $10.94 $9.92 $385.66
3951 Continuous Home Care – Min 11 Hours $401.28 $12.04 $9.92 $423.24
3952 Continuous Home Care – Min 12 Hours $437.76 $13.13 $9.92 $460.81
3953 Continuous Home Care – Min 13 Hours $474.24 $14.23 $9.92 $498.39
3954 Continuous Home Care – Min 14 Hours $510.72 $15.32 $9.92 $535.96
3955 Continuous Home Care – Min 15 Hours $547.20 $16.42 $9.92 $573.54
3956 Continuous Home Care – Min 16 Hours $583.68 $17.51 $9.92 $611.11
3957 Continuous Home Care – Min 17 Hours $620.16 $18.60 $9.92 $648.68
3958 Continuous Home Care – Min 18 Hours $656.64 $19.70 $9.92 $686.26
3959 Continuous Home Care – Min 19 Hours $693.12 $20.79 $9.92 $723.83
3960 Continuous Home Care – Min 20 Hours $729.60 $21.89 $9.92 $761.41
3961 Continuous Home Care – Min 21 Hours $766.08 $22.98 $9.92 $798.98
3962 Continuous Home Care – Min 22 Hours $802.56 $24.08 $9.92 $836.56
3963 Continuous Home Care – Min 23 Hours $839.04 $25.17 $9.92 $874.13
3964 Continuous Home Care – Min 24 Hours $875.52 $26.27 $9.92 $911.71
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.35 $0.25 $0.50 $9.10
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $250.84 $7.53 $9.92 $268.29
3970 Routine Home Care w/Escort $162.54 $4.88 $9.92 $177.34
3971 Continuous Home Care w/AIDS Min 8 Hours $308.47 $9.25 $9.92 $327.64
3972 Continuous Home Care w/AIDS Min 9 Hours $347.03 $10.41 $9.92 $367.36
3973 Continuous Home Care w/AIDS Min 10 Hours $385.58 $11.57 $9.92 $407.07
3974 Continuous Home Care w/AIDS Min 11 Hours $424.14 $12.72 $9.92 $446.78
3975 Continuous Home Care w/AIDS Min 12 Hours $462.70 $13.88 $9.92 $486.50
3976 Continuous Home Care w/AIDS Min 13 Hours $501.26 $15.04 $9.92 $526.22
3977 Continuous Home Care w/AIDS Min 14 Hours $539.82 $16.19 $9.92 $565.93
3978 Continuous Home Care w/AIDS Min 15 Hours $578.38 $17.35 $9.92 $605.65
3979 Continuous Home Care w/AIDS Min 16 Hours $616.93 $18.51 $9.92 $645.36
3980 Continuous Home Care w/AIDS Min 17 Hours $655.49 $19.66 $9.92 $685.07
3981 Continuous Home Care w/AIDS Min 18 Hours $694.05 $20.82 $9.92 $724.79
3982 Continuous Home Care w/AIDS Min 19 Hours $732.61 $21.98 $9.92 $764.51
3983 Continuous Home Care w/AIDS Min 20 Hours $771.17 $23.14 $9.92 $804.23
3984 Continuous Home Care w/AIDS Min 21 Hours $809.73 $24.29 $9.92 $843.94
3985 Continuous Home Care w/AIDS Min 22 Hours $848.28 $25.45 $9.92 $883.65
3986 Continuous Home Care w/AIDS Min 23 Hours $886.84 $26.61 $9.92 $923.37
3987 Continuous Home Care w/AIDS Min 24 Hours $925.40 $27.76 $9.92 $963.08
3988 General Inpatient w/ AIDS $746.56 $22.40 $9.92 $778.88
3989 Routine Home Care w/ AIDS Escort $268.58 $8.06 $9.92 $286.56
3991 Service Intensity Add–on $37.74 $1.13 $0.00 $38.87

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Syracuse

Hospice Rate Sheets for the Counties of: MADISON, ONONDAGA, OSWEGO

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $160.43 $4.81 $9.92 $175.16
3946 Inpatient Respite $180.88 $5.43 $9.92 $196.23
3947 General Inpatient Care $738.74 $22.16 $9.92 $770.82
3948 Continuous Home Care – Min 8 Hours $323.34 $9.70 $9.92 $342.96
3949 Continuous Home Care – Min 9 Hours $363.76 $10.91 $9.92 $384.59
3950 Continuous Home Care – Min 10 Hours $404.18 $12.13 $9.92 $426.23
3951 Continuous Home Care – Min 11 Hours $444.59 $13.34 $9.92 $467.85
3952 Continuous Home Care – Min 12 Hours $485.01 $14.55 $9.92 $509.48
3953 Continuous Home Care – Min 13 Hours $525.43 $15.76 $9.92 $551.11
3954 Continuous Home Care – Min 14 Hours $565.85 $16.98 $9.92 $592.75
3955 Continuous Home Care – Min 15 Hours $606.26 $18.19 $9.92 $634.37
3956 Continuous Home Care – Min 16 Hours $646.68 $19.40 $9.92 $676.00
3957 Continuous Home Care – Min 17 Hours $687.10 $20.61 $9.92 $717.63
3958 Continuous Home Care – Min 18 Hours $727.52 $21.83 $9.92 $759.27
3959 Continuous Home Care – Min 19 Hours $767.93 $23.04 $9.92 $800.89
3960 Continuous Home Care – Min 20 Hours $808.35 $24.25 $9.92 $842.52
3961 Continuous Home Care – Min 21 Hours $848.77 $25.46 $9.92 $884.15
3962 Continuous Home Care – Min 22 Hours $889.19 $26.68 $9.92 $925.79
3963 Continuous Home Care – Min 23 Hours $929.60 $27.89 $9.92 $967.41
3964 Continuous Home Care – Min 24 Hours $970.02 $29.10 $9.92 $1,009.04
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $9.04 $0.27 $0.50 $9.81
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $277.92 $8.34 $9.92 $296.18
3970 Routine Home Care w/Escort $178.17 $5.35 $9.92 $193.44
3971 Continuous Home Care w/AIDS Min 8 Hours $355.01 $10.65 $9.92 $375.58
3972 Continuous Home Care w/AIDS Min 9 Hours $399.38 $11.98 $9.92 $421.28
3973 Continuous Home Care w/AIDS Min 10 Hours $443.76 $13.31 $9.92 $466.99
3974 Continuous Home Care w/AIDS Min 11 Hours $488.13 $14.64 $9.92 $512.69
3975 Continuous Home Care w/AIDS Min 12 Hours $532.51 $15.98 $9.92 $558.41
3976 Continuous Home Care w/AIDS Min 13 Hours $576.89 $17.31 $9.92 $604.12
3977 Continuous Home Care w/AIDS Min 14 Hours $621.26 $18.64 $9.92 $649.82
3978 Continuous Home Care w/AIDS Min 15 Hours $665.64 $19.97 $9.92 $695.53
3979 Continuous Home Care w/AIDS Min 16 Hours $710.01 $21.30 $9.92 $741.23
3980 Continuous Home Care w/AIDS Min 17 Hours $754.39 $22.63 $9.92 $786.94
3981 Continuous Home Care w/AIDS Min 18 Hours $798.77 $23.96 $9.92 $832.65
3982 Continuous Home Care w/AIDS Min 19 Hours $843.14 $25.29 $9.92 $878.35
3983 Continuous Home Care w/AIDS Min 20 Hours $887.52 $26.63 $9.92 $924.07
3984 Continuous Home Care w/AIDS Min 21 Hours $931.89 $27.96 $9.92 $969.77
3985 Continuous Home Care w/AIDS Min 22 Hours $976.27 $29.29 $9.92 $1,015.48
3986 Continuous Home Care w/AIDS Min 23 Hours $1,020.64 $30.62 $9.92 $1,061.18
3987 Continuous Home Care w/AIDS Min 24 Hours $1,065.02 $31.95 $9.92 $1,106.89
3988 General Inpatient w/ AIDS $821.04 $24.63 $9.92 $855.59
3989 Routine Home Care w/ AIDS Escort $295.66 $8.87 $9.92 $314.45
3991 Service Intensity Add–on $41.82 $1.25 $0.00 $43.07

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Utica–Rome

Hospice Rate Sheets for the Counties of: MADISON, ONONDAGA, OSWEGO

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $151.56 $4.55 $9.92 $166.03
3946 Inpatient Respite $173.01 $5.19 $9.92 $188.12
3947 General Inpatient Care $700.71 $21.02 $9.92 $731.65
3948 Continuous Home Care – Min 8 Hours $305.47 $9.16 $9.92 $324.55
3949 Continuous Home Care – Min 9 Hours $343.65 $10.31 $9.92 $363.88
3950 Continuous Home Care – Min 10 Hours $381.83 $11.45 $9.92 $403.20
3951 Continuous Home Care – Min 11 Hours $420.02 $12.60 $9.92 $442.54
3952 Continuous Home Care – Min 12 Hours $458.20 $13.75 $9.92 $481.87
3953 Continuous Home Care – Min 13 Hours $496.38 $14.89 $9.92 $521.19
3954 Continuous Home Care – Min 14 Hours $534.57 $16.04 $9.92 $560.53
3955 Continuous Home Care – Min 15 Hours $572.75 $17.18 $9.92 $599.85
3956 Continuous Home Care – Min 16 Hours $610.93 $18.33 $9.92 $639.18
3957 Continuous Home Care – Min 17 Hours $649.12 $19.47 $9.92 $678.51
3958 Continuous Home Care – Min 18 Hours $687.30 $20.62 $9.92 $717.84
3959 Continuous Home Care – Min 19 Hours $725.48 $21.76 $9.92 $757.16
3960 Continuous Home Care – Min 20 Hours $763.67 $22.91 $9.92 $796.50
3961 Continuous Home Care – Min 21 Hours $801.85 $24.06 $9.92 $835.83
3962 Continuous Home Care – Min 22 Hours $840.03 $25.20 $9.92 $875.15
3963 Continuous Home Care – Min 23 Hours $878.22 $26.35 $9.92 $914.49
3964 Continuous Home Care – Min 24 Hours $916.40 $27.49 $9.92 $953.81
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.65 $0.26 $0.50 $9.41
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $262.55 $7.88 $9.92 $280.35
3970 Routine Home Care w/Escort $169.30 $5.08 $9.92 $184.30
3971 Continuous Home Care w/AIDS Min 8 Hours $328.60 $9.86 $9.92 $348.38
3972 Continuous Home Care w/AIDS Min 9 Hours $369.67 $11.09 $9.92 $390.68
3973 Continuous Home Care w/AIDS Min 10 Hours $410.75 $12.32 $9.92 $432.99
3974 Continuous Home Care w/AIDS Min 11 Hours $451.82 $13.55 $9.92 $475.29
3975 Continuous Home Care w/AIDS Min 12 Hours $492.90 $14.79 $9.92 $517.61
3976 Continuous Home Care w/AIDS Min 13 Hours $533.97 $16.02 $9.92 $559.91
3977 Continuous Home Care w/AIDS Min 14 Hours $575.04 $17.25 $9.92 $602.21
3978 Continuous Home Care w/AIDS Min 15 Hours $616.12 $18.48 $9.92 $644.52
3979 Continuous Home Care w/AIDS Min 16 Hours $657.19 $19.72 $9.92 $686.83
3980 Continuous Home Care w/AIDS Min 17 Hours $698.27 $20.95 $9.92 $729.14
3981 Continuous Home Care w/AIDS Min 18 Hours $739.34 $22.18 $9.92 $771.44
3982 Continuous Home Care w/AIDS Min 19 Hours $780.42 $23.41 $9.92 $813.75
3983 Continuous Home Care w/AIDS Min 20 Hours $821.49 $24.64 $9.92 $856.05
3984 Continuous Home Care w/AIDS Min 21 Hours $862.57 $25.88 $9.92 $898.37
3985 Continuous Home Care w/AIDS Min 22 Hours $903.64 $27.11 $9.92 $940.67
3986 Continuous Home Care w/AIDS Min 23 Hours $944.72 $28.34 $9.92 $982.98
3987 Continuous Home Care w/AIDS Min 24 Hours $985.79 $29.57 $9.92 $1,025.28
3988 General Inpatient w/ AIDS $778.77 $23.36 $9.92 $812.05
3989 Routine Home Care w/ AIDS Escort $280.29 $8.41 $9.92 $298.62
3991 Service Intensity Add–on $39.51 $1.19 $0.00 $40.70

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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SMSA: Rural

Hospice Rate Sheets for the Counties of: ALLEGANY, CATTARAUGUS, CAYUGA, CHAUTAUQUA, CHENANGO, CLINTON, COLUMBIA, CORTLAND, DELAWARE, ESSEX, FRANKLIN, FULTON, GENESEE, HAMILTON, JEFFERSON, LEWIS, OTSEGO, SCHOHARIE, SCHUYLER, SENECA, ST. LAWRENCE, STEUBEN, SULLIVAN, TOMPKINS, ULSTER, WYOMING, YATES

Rate
Code
Description Base Rate WRP
Add–on *
RTR
Add–on *
Total
w/ addons
3945 Routine Home Care $143.88 $4.32 $9.92 $158.12
3946 Inpatient Respite $166.20 $4.99 $9.92 $181.11
3947 General Inpatient Care $667.78 $20.03 $9.92 $697.73
3948 Continuous Home Care – Min 8 Hours $289.98 $8.70 $9.92 $308.60
3949 Continuous Home Care – Min 9 Hours $326.23 $9.79 $9.92 $345.94
3950 Continuous Home Care – Min 10 Hours $362.48 $10.87 $9.92 $383.27
3951 Continuous Home Care – Min 11 Hours $398.73 $11.96 $9.92 $420.61
3952 Continuous Home Care – Min 12 Hours $434.98 $13.05 $9.92 $457.95
3953 Continuous Home Care – Min 13 Hours $471.22 $14.14 $9.92 $495.28
3954 Continuous Home Care – Min 14 Hours $507.47 $15.22 $9.92 $532.61
3955 Continuous Home Care – Min 15 Hours $543.72 $16.31 $9.92 $569.95
3956 Continuous Home Care – Min 16 Hours $579.97 $17.40 $9.92 $607.29
3957 Continuous Home Care – Min 17 Hours $616.21 $18.49 $9.92 $644.62
3958 Continuous Home Care – Min 18 Hours $652.46 $19.57 $9.92 $681.95
3959 Continuous Home Care – Min 19 Hours $688.71 $20.66 $9.92 $719.29
3960 Continuous Home Care – Min 20 Hours $724.96 $21.75 $9.92 $756.63
3961 Continuous Home Care – Min 21 Hours $761.21 $22.84 $9.92 $793.97
3962 Continuous Home Care – Min 22 Hours $797.45 $23.92 $9.92 $831.29
3963 Continuous Home Care – Min 23 Hours $833.70 $25.01 $9.92 $868.63
3964 Continuous Home Care – Min 24 Hours $869.95 $26.10 $9.92 $905.97
3965 Hospice Inpatient Respite Care Coinsurance Rate –
  5% of 3946 $8.31 $0.25 $0.50 $9.06
3966 Drugs Coinsurance Rate $1.00 $0.00 $0.00 $1.00
3969 Routine Home Care w/AIDS $249.25 $7.48 $9.92 $266.65
3970 Routine Home Care w/Escort $161.62 $4.85 $9.92 $176.39
3971 Continuous Home Care w/AIDS Min 8 Hours $305.72 $9.17 $9.92 $324.81
3972 Continuous Home Care w/AIDS Min 9 Hours $343.94 $10.32 $9.92 $364.18
3973 Continuous Home Care w/AIDS Min 10 Hours $382.15 $11.46 $9.92 $403.53
3974 Continuous Home Care w/AIDS Min 11 Hours $420.37 $12.61 $9.92 $442.90
3975 Continuous Home Care w/AIDS Min 12 Hours $458.59 $13.76 $9.92 $482.27
3976 Continuous Home Care w/AIDS Min 13 Hours $496.80 $14.90 $9.92 $521.62
3977 Continuous Home Care w/AIDS Min 14 Hours $535.02 $16.05 $9.92 $560.99
3978 Continuous Home Care w/AIDS Min 15 Hours $573.23 $17.20 $9.92 $600.35
3979 Continuous Home Care w/AIDS Min 16 Hours $611.45 $18.34 $9.92 $639.71
3980 Continuous Home Care w/AIDS Min 17 Hours $649.66 $19.49 $9.92 $679.07
3981 Continuous Home Care w/AIDS Min 18 Hours $687.88 $20.64 $9.92 $718.44
3982 Continuous Home Care w/AIDS Min 19 Hours $726.09 $21.78 $9.92 $757.79
3983 Continuous Home Care w/AIDS Min 20 Hours $764.31 $22.93 $9.92 $797.16
3984 Continuous Home Care w/AIDS Min 21 Hours $802.52 $24.08 $9.92 $836.52
3985 Continuous Home Care w/AIDS Min 22 Hours $840.74 $25.22 $9.92 $875.88
3986 Continuous Home Care w/AIDS Min 23 Hours $878.95 $26.37 $9.92 $915.24
3987 Continuous Home Care w/AIDS Min 24 Hours $917.17 $27.52 $9.92 $954.61
3988 General Inpatient w/ AIDS $742.17 $22.27 $9.92 $774.36
3989 Routine Home Care w/ AIDS Escort $266.99 $8.01 $9.92 $284.92
3991 Service Intensity Add–on $37.50 $1.13 $0.00 $38.63

* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable

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